Toilet Adjustments

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GiuliaInDenver

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My dad is now at the stage where getting up and down from the toilet to his PWC is quite challenging. I also think he is struggling to wipe himself and keep himself clean (he still has mobility in his arms and hands but limited dexterity and no fine motor skills). Also, he cannot wash his hands by himself.

Having said this, I am looking into two separate things: 1) toilet raiser, and 2) a bidet seat. However, I cannot seem to find out if these things can be used together. Does anyone have suggestions for how they went about this issue?

I am looking for something cost-effective as I imagine that it will be a question of months that he will be able to control his bowel movements & use the toilet himself. I am unfamiliar of what that next stage will look like and any advice on how to prepare/think ahead will be so greatly appreciated.

Warmly,
Giulia
 

lgelb

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Very sorry to welcome you to our ranks, Giulia.

A riser is as you mention a short-term solution. We used the Tall-Ette available on Amazon but you should measure your own space. I have no experience with bidets so will leave that to others. But if his strength is waning, I would also begin looking into sources for a Hoyer lift, such as a loaner from your ALSA chapter.

Best,
Laurie
 

Jrzygrl

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We found that a Toilevator (around $200 on Amazon) which is placed under the toilet, was much more stable than a riser. You can then use a bidet seat with no problem. We have a Brondell, but there are others. Look around for features and prices - I think we ended up getting it at Home Depot. We also had grab bars on both sides of the toilet. First, my DH was able to transfer on to the toilet with assistance, then we used a slide board (Beasy board), then transferred him using a Hoyer lift with a Liko Highback sling. This was the only sling we could find to get him upright enough. It also allowed us to get his pants on and off easier. When his hands got too weak, someone else would use the remote for him. He used this set-up for a relatively long time (a few years), until his core got too weak and he couldn't sit upright. Then we used the Hoyer to get him to a semi-reclined commode chair.
 

Kristina1

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We use them together with no problems. We got a riser on amazon for about $30, and we have our toto washlet bidet seat on top of it. works beautifully. toilet is a little harder to clean with the riser, but not a big deal.
 

nona

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I have both, and my father screwed toilet bars into the floor. I don't recommend running into your toilet with your power wheelchair though... Unnecessary plumbing expense!
 

Dee Dee 0617

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Hi, Just out of curiosity what does your dad want to do? I had to decide quickly to choose a free standing commode when I could no longer fit my wheelchair into a transferable position. A bidet is a wonderful invention, but this progresses at indeterminate rates, I would hate to see you have regret for the purchase. If your dad doesn't want to be hoisted you may want to talk to him about what his definition of personal dignity is at this stage. I call my hoyer Stork. He delivers me to all the locations in my home.
 

Doglady

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I’ve had a toto bidet seat on a comfort height toilet for 8 months and loved it. The bidet seat is too high in the back for my commode chair to roll over the toilet. So am now switching to a non-electric bidet attachment with a regular toilet seat. The attachment wont be as wonderful but it’s a lot cheaper and should be usable to me now. Suggest you check both options out, and decide what to do depending on your other equipment and needs. Best wishes.
 

KimT

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I use the BioBidet 2000. No need for toilet paper. I recommend a bidet toilet seat for everyone. Amazon had the Biobidet on sale for about $450 a month ago.
 

Doglady

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Guilia-
It’s good that you are thinking long term. My bidet seat is no longer useful to me because my commode chair can’t fit over it and the seat doesn’t operate unless there is weight on it.

If your dad is having trouble getting on and off the toilet from his wheelchair a home health care visit from an Occupational Therapist should be ordered by his doctor. Medicare will pay for this. The OT will evaluate his needs as well as the current set up and recommend a safe method of accommodation.

About one month ago I had to give up on transfers to my toilet from my PWC due to my arms and legs becoming too weak and a couple of falls. The handrails and raised toilet were not enough for me.

The OT requested appropriate equipment from the als loan pool and advised us that a Hoyer lift was too big for our bathroom. I hope your bathroom is big enough for a lift.

In addition to a hoyer lift and sling there are standing lifts - sometimes called easy lift s. You need to have some weight bearing ability to use the standing lift but it is slightly smaller than a hoyer with a sling. We tested both of those in my bathroom and they were both too large but maybe one will work for you. Perhaps you and your dad can use a standing lift. My best option now is a standing lift and a rolling shower commode chair in my bedroom and to either use the commode pail there or be wheeled into the bathroom and use the commode chair right over the toilet.

Does your father qualify for VA assistance? If so they might pay for a ceiling mounted lift system and other accommodations he needs. Fingers crossed!
Mary
 

Jimi

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Hope this helps ,
ALS, male, 160lbs, 5’9”, paralyzed from the shoulders down. Sleep/live in a power recliner/lift chair. Toileting/bath tips:
1) I don’t have a very spacious apartment, but there is enough room for a rolling commode chair to go over the toilet. GET A TILTING ONE! This allows for lowering me into position on the chair while tilted back and gravity does most of the work. One person does this with practice. Without the tilting function it is very difficult/impossible to get me all the way back in the seat. I use the Showerbuddy SB3T. I bathe, do my daily cough assist breathing exercises all from here. Flushable wipes, soap and water, no bidet. Squeaky clean.
2) Sponge bath - Dr. Bronner’s - Pure-Castile Liquid Soap Citrus. Worth every penny. I use this for body/hair. Not drying and rinses easily. Was using crappy soap and it was building up and I thought I had dry skin and dandruff. Switching soaps and it’s never been an issue since.
3) I use a Drive Medical Padded U Sling. I wear flannel pants with a modified fly - a little longer with velcro. Happy to be a guy. Going #1 is easy, sorry gals. Partially pull down on hips, recliner/lift chair in up position with caregiver in front, lean me forward and place sling behind back. Lower chair, finish sling/leg placement. While in the air, pants go about 80% of the way down. Lift to shower/commode chair (tilted back). Lower down,pants down completely. Tilt forward and head over on top of the toilet
4) Currently using Lumex Hydraulic Patient Lift, LF1031. It’s pretty small and works well. Nothing fancy and not expensive. But reliable. Have used 2 different electric ones in the past and one had a problem with the charger.
5) I eat twice a day, fairly healthy, but more important is to drink enough water. I take a probiotic every morning, small dose of vitamin d3 to make up for the lack of sun and a magnesium supplement which is good for bm regularity. My system moves slower than it used to from the sedentary lifestyle, but being consistent has made my bathroom trips low stress and reliable at the same time every day. Gotta be regular to get regular
6) Transitioning to the lift was intimidating to me at first, but turned out to be pretty simple. I never had any help from a pt. Maybe it would have been even easier. That’s never been my style. Hope some of this makes things easier for others
 

Doglady

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Hi Jimi-
Thanks for taking the trouble to describe your system. I’m not only impressed at your toileting and lifestyle accommodations but your ability to compose this very helpful message.
Mary
 

Jimi

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Thanks Mary,
I appreciate that you understand the effort. I'm writing this on my computer with only the use of my head movement. It's time consuming. But I am such a perfectionist that I have to describe everything in detail or else I feel like I didn't do my best. I had so many things to learn to get to this point and I wish to save others the trouble. There are many new things I must figure out how to deal with, but as I am at the moment, it's a piece of cake.... Time will tell how much I can adapt to a trach and feeding tube, if I decide to go that route. Not sure how I will do. I didn't think I would make it this far and be comfortable, happy and medication/drug free
 
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